雷火灸治疗膝骨关节炎临床疗效系统评价和Meta分析

A Systematic Review and Meta-analysis of Thunder-fire Moxibustion for Knee Osteoarthritis

目的评价雷火灸治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法计算机检索中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普中文期刊服务平台、PubMed、EMBASE、Cochrane Library中的临床随机对照试验(RCT),按照纳入及排除标准筛选、提取数据,进行质量评价,并用RevMan 5.4软件进行Meta分析。结果最终纳入16篇RCT,共计1593例患者,Meta分析结果显示:雷火灸治疗KOA临床有效率试验组高于对照组,视觉模拟评分法评分(VAS)、西安大略麦马斯特大学骨关节炎指数评分(WOMAC)、中医症状积分试验组低于对照组,差异均具有统计学意义。结论雷火灸治疗KOA疗效肯定且安全可靠,临床有效率、止痛效果、改善僵硬、日常活动度及中医症状效果均优于其他疗法,在有效率和止痛方面,单独雷火灸优于其他疗法,雷火灸配合其他疗法优于单独使用其他疗法,值得在临床中推广应用。

Objective To evaluate the clinical efficiency of thunder-fire moxibustion on knee osteoarthritis(KOA).Methods Randomized controlled trials(RCT)were retrieved from China National Knowledge Infrastructure,China Biology Medicine disc,WanFang Data Knowledge Service Platform,VIP Database for Chinese Technical Periodicals,PubMed,EMBASE and Cochrane Library.The RCTs were screened according to inclusion and exclusion criteria,the data were extracted,the quality was evaluated,and Meta-analysis was performed with Revman5.4 software.Results A total of 1593 patients were included in 16 RCTs.Meta-analysis results showed that the clinical effective rate of thunder-fire moxibustion for KOA in the experimental group was higher than that in the control group,while VAS score,WOMAC scores and TCM symptom score in the experimental group were lower than those in the control group,the differences were statistically significant.Conclusion Thunder-fire moxibustion for KOA is effective,safe and reliable.Clinical effective rate,analgesic effect,improving effects of stiffness,daily activities and TCM symptoms were better than other treatments.In terms of effective rate and analgesic effect,thunder-fire moxibustion used alone was better than other treatments,thunder-fire moxibustion in combination with other treatments was better than other treatments used alone.Thunder-fire moxibustion is worth popularizing in clinical application.